Femoral lengthening during hip resurfacing arthroplasty: a new surgical procedure

Correction of leg length discrepancy during hip arthroplasty is a technical challenge. Although resurfacing proposed to young subjects presents a number of advantages (stability, bone stock, etc.), it does not correct leg length discrepancy. We propose an original femoral lengthening technique concomitant to resurfacing performed through the same approach, consisting in a Z-shaped subtrochanteric osteotomy. Resurfacing was performed first and the femoral and acetabular reaming material was used for autografting. The series comprised five cases followed for a mean 42.2 months (range, 33-64 months). The mean surgical time was 100 min (range, 76-124 min). Weightbearing was authorized in all cases at the 8th week. The mean lengthening was 32 mm (range, 25-40 mm). Healing was observed in all cases. This surgical technique, reserved for very young subjects who accept an 8-week postoperative period without weightbearing, can be proposed in cases with substantial preoperative leg length discrepancy.